Testing the perfectionism model of binge eating in mother-daughter dyads: a mixed longitudinal and daily diary study

A meta-analysis of disordered eating and its association with self-criticism and self-compassion

OBJECTIVE

Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE.

METHOD

Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted.

RESULTS

Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88).

DISCUSSION

Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE.

PUBLIC SIGNIFICANCE STATEMENT

Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.

Perfectionism and binge eating association: a systematic review and meta-analysis

BACKGROUND

Perfectionism is considered a vulnerability factor for eating disorders. However, the role of perfectionism in binge eating needs clarification due to notably inconsistencies between studies. The purpose to this study was to conduct a systematic review and meta-analysis to estimate the perfectionism-binge eating association.

METHOD

Systematic review was performed according to the PRISMA 2020 statement. Four databases (Web of Science, Scopus, PsycINFO and Psicodoc) were searched to identify studies published until September 2022. The literature search yielded 30 published articles (N = 9392) that provided 33 independent estimations of the correlation between the two variables.

RESULTS

Random-effects meta-analysis revealed a small-to-moderate positive average effect size between general perfectionism and binge eating (r₊ = .17) with a large heterogeneity. Perfectionistic Concerns showed a significant small-to-moderate relationship with binge eating (r₊ = .27), whereas Perfectionistic Strivings presented a negligible relationship with binge eating (r₊ = .07). Moderator analyses showed that the age, the type of the sample, the study design, and the tools for assessing both variables were statistically associated with the perfectionism-binge eating effect sizes.

CONCLUSIONS

Our findings suggest that Perfectionism Concerns are closely associated with binge eating symptomatology. This relationship might be moderated by certain variables, especially by the clinical or non-clinical nature of the sample and the instrument employed to assess binge eating.

Perfectionistic concerns and binge eating in mother-daughter dyads: An actor-partner interdependence model

Perfectionism is linked to a range of psychopathology, including binge eating. Our study enhanced understanding of the role maternal perfectionistic concerns play in the maintenance of binge eating in emerging adult daughters. A sample of 73 mother-daughter dyads (mean age = 49.51 years for mothers and 19.89 years for daughters) reported on perfectionistic concerns (composite of doubt about actions and concern over mistakes), binge eating, and binge drinking (composite of frequency, severity, and perceptions). Using actor-partner interdependence modelling, mothers' and daughters' perfectionistic concerns were positively associated with their own binge eating (actor effects). Mothers' perfectionistic concerns were positively associated with daughters' binge eating (partner effect), but not vice versa. Perfectionistic concerns did not show significant actor or partner associations with binge drinking, supporting the specificity of our model. Findings suggest binge eating has characterological and interpersonal antecedents.

Investigating the Relationship Between Perfectionistic Self-Presentation and Social Anxiety Using Daily Diary Methods: A Replication

Worrying about the negative consequences of appearing imperfect to others (i.e., perfectionistic self-presentation) is conceptually related to social anxiety. Mackinnon, Battista, Sherry and Stewart (2014) tested whether perfectionistic self-presentation could predict social anxiety beyond several important covariates using a 21-day daily measurement approach. We sought to replicate Mackinnon et al.’s (2014) findings using the same daily diary methodology. Participants included 263 young adults (79.9% women;M age = 21.4) who completed a series of questionnaires once per day for 21 days. Participants completed measures of perfectionistic self-presentation, perfectionism cognitions, social anxiety, depressed mood and socially prescribed perfectionism. Intraclass correlations suggested measures had both within-subjects and between-subjects variability. Confirmatory factor analyses supported the a-priori factor structures at both levels. Using multilevel structural equation modeling, we showed that perfectionistic self-presentation predicted social anxiety even when controlling for socially prescribed perfectionism, depressed mood and perfectionism cognitions at both levels, replicating Mackinnon et al (2014). Our replication suggests that perfectionistic self-presentation is an important predictor of daily social anxiety. Intervention efforts may wish to target perfectionistic self-presentation in order to better help treat those with social anxiety. Open data/methods: https://osf.io/ty2aj/.

Are perfectionistic concerns an antecedent of or a consequence of binge eating, or both? A short-term four-wave longitudinal study of undergraduate women

The perfectionism model of binge eating (PMOBE) posits perfectionistic concerns are a vulnerability factor for binge eating. And evidence indicates perfectionistic concerns and binge eating correlate positively. However, the direction of this relationship is seldom studied. Accordingly, it is unclear whether perfectionistic concerns represent an antecedent of binge eating (a vulnerability effect with perfectionistic concerns predicting increases in binge eating), a consequence of binge eating (a complication effect with binge eating predicting increases in perfectionistic concerns), or both (reciprocal relations with perfectionistic concerns predicting increases in binge eating and vice versa). To address these questions, we studied 200 undergraduate women using a 4-week, 4-wave cross-lagged longitudinal design. Consistent with the PMOBE, perfectionistic concerns predicted increased binge eating (vulnerability effect). But, binge eating did not predict increased perfectionistic concerns (complication effect). Findings support the long-held theory that perfectionistic concerns are part of the premorbid personality of women vulnerable to binge eating.

Parental bonds and body dissatisfaction in a clinical sample: The mediating roles of attachment anxiety and media internalization

We evaluated an attachment theory model in which mother and father care were hypothesized to be indirectly related to body dissatisfaction mediated by attachment anxiety and media internalization. Participants were 232 women diagnosed with an eating disorder who completed a retrospective measure of parental bonds, and measures of attachment anxiety, media internalization, and body image. Mother care was negatively associated with body dissatisfaction, suggesting that recollection of mothers as less caring was directly related to poorer body image. Lower father care, was indirectly associated with greater body dissatisfaction mediated by higher attachment anxiety and higher media internalization. That is, women with an eating disorder who recollected fathers as less caring had higher attachment anxiety, which was related to greater internalizing of media-related thin ideals, that in turn was associated with poorer body image. Mothers and fathers may impact body dissatisfaction by differing mechanisms in clinical samples.

Eating behaviors, body image, perfectionism, and self-esteem in a sample of Portuguese girls

OBJECTIVE

Eating disorders are an increasingly prevalent health problem among adolescent girls. It is well known that biological, psychosocial, and family-related factors interact in the development of this group of disorders. However, the mechanisms underlying the interaction between these variables are still poorly understood, especially in Portuguese adolescents. The aim of this study was to investigate the relationship between eating behaviors, body dissatisfaction, self-esteem, and perfectionism in a sample of Portuguese girls.

METHOD

A community sample of 575 Portuguese girls attending secondary school, answered self-report questionnaires including data on weight, height, and the Portuguese versions of the Contour Figures Rating Scale, the Child and Adolescent Perfectionism Scale, the Children Eating Attitudes Test, and the Rosenberg Self-Esteem Scale. SPSS version 20.0 for Windows was used for statistical analyses.

RESULTS

High scores in the Children Eating Attitudes Test were associated with significantly higher levels of body dissatisfaction (r = 0.339), socially prescribed perfectionism (r = 0.175), self-oriented perfectionism (r = 0.211), and low self-esteem (r = -0.292) (all p < 0.001). Self-oriented perfectionism partially mediated the relation between body dissatisfaction and disordered eating behaviors.

CONCLUSION

In this sample, dysfunctional eating behaviors appeared to correlate strongly with body dissatisfaction, low self-esteem, and perfectionism in girls. These themes should be addressed among female adolescents in the community.

Father-daughter relationship and the severity of eating disorders

BACKGROUND

Mother-daughter relationship was the focus of studies on the development of eating disorders (ED) for many years. This study aimed to examine the association between the father-daughter relationship and ED and depressive symptoms.

METHODS

Fifty-three women diagnosed with ED were compared to a psychiatric control group (n=26) and to healthy participants (n=60) regarding their perception of their fathers and the relationship with them. Assessments were done using the Parental Bonding Instrument, the Eating Disorders Questionnaire, the Body Shape Questionnaire, the Eating Attitude Test, and the Beck Depression Inventory as well as narrative-based methods.

RESULTS

Fathers' negative attributes were significantly associated with ED and depressive symptom. Two profiles of father-daughter relationship were found, the "caring and benevolent" relationship and the "overprotective and avoidant" one. In the latter, patients displayed significantly higher levels of food-restraint, more concerns about eating and about their body shape and appearance, and higher levels of depression.

DISCUSSION

Negative perception of the father's parenting style as well as the quality of the relationship with him are crucial for the understanding of the development and persistence of ED. Therapeutic programs for ED should focus not only on the relationship with the mother but must also address the relationship with the father.

Communication with parents and body satisfaction in college students

OBJECTIVE

This study examined how communication with parents is related to college students' body satisfaction.

PARTICIPANTS AND METHODS

Participants (N = 134; 58 males and 76 females) completed a survey in March 2011 assessing body satisfaction and perceptions of communication with mothers and fathers.

RESULTS

Daughters' body satisfaction was negatively correlated with perceptions of problematic communication with mothers and fathers. Sons' body satisfaction was positively correlated with open communication with their mothers and negatively correlated with problematic communication with their mothers.

CONCLUSIONS

Findings indicated problematic communication with mothers was the most powerful predictor of daughters' body satisfaction, whereas open communication with mothers was the best predictor of sons' body satisfaction.